EVENING. Health.

Genetics And Insurance

May 24, 1994|By Angela Dire, Colorado Springs Gazette.

They will tell us secrets we would love to know and would never, ever want to know. Who among us will be short or tall? Who will have blue eyes or brown eyes? Who among us will inevitably go blind? Who will likely lose their memory? Who will develop incurable cancer?

The answers lie within our genes, the microscopic strands of DNA that form the blueprint for a human life.

A blueprint so detailed in its instructions that, unfolded, it could stretch to the moon and back again 1 million times.

A blueprint whose secrets are unfolding before scientists now more than at any time since an Austrian monk in the mid-1800s first studied heredity by mixing and sowing pea plants.

Geneticists can pinpoint to a single gene the origin of more than 4,000 hereditary diseases, from cystic fibrosis to ovarian cancer. They can pinpoint genes and chromosomes that play a part in many other maladies such as alcoholism, Alzheimer's disease.

With a simple blood test, they can determine whether someone has the gene causing a kind of colon cancer.

The implications are profound. Genetic tests, though still exotic and costly, may soon provide treatment and cures for life-threatening illnesses years before symptoms even develop.

Yet a growing number of public policy experts and medical ethicists see darker implications.

"Suppose a person undergoes a genetic test and finds he carries a gene that is identified with life-threatening heart diseases," Steve Brown of the Council of State Governments recently wrote.

"The person's physician advises him he is at six times the normal risk for heart disease than the general population. This information, if revealed to a potential insurer, might raise the cost of the insurance. Families might even avoid medically beneficial treatments for fear that test results might precipitate the loss of insurance coverage."

It's a growing concern in a number of states. About a dozen states have some kind of restrictions on the use of genetic tests for insurance underwriting.

A Wisconsin law, which appears to be the strictest, bans the use of test information by health insurance providers as well as life and disability insurers. Last week, the Colorado Senate approved a bill that would prohibit companies from using genetic tests to deny health insurance.

Computerized documentation of gene sequences could drive down test costs and make them more widely used.

The insurance industry, naturally, resists the movement to restrict genetic information. The tests are no different, insurers insist, from information they now use to determine whether a potential client is a risk. And it would be unfair for potential customers to have access to information and be able to keep it secret when they apply for insurance, insurers say.

"We just see it as setting up a fearful precedent-a type of medical information we can't have access to. If it starts there, where does it end? It really hinders our ability to offer insurance at affordable prices and make it as widely available to consumers as it is now," said Debbie Chase, spokeswoman for the American Council of Life Insurance.

Others say concern over genetic testing will become moot if the country adopts universal health insurance.

"In fact, the industry is moving away from relying upon the use of underwriting. We propose that everybody in the U.S. have cradle-to-grave coverage without regard for existing illness or new illness," said Richard Coorsh, spokesman for the Health Insurance Association of America.

But medical ethicists say the problem of genetic tests won't go away, especially as the country moves toward a managed health-care system in which prevention of illness is stressed.

"There's going to be pressure under a system that emphasizes prevention to have genetic tests," says Bill Allen, an instructor of medical humanities at the University of Florida Medical School. "It becomes an issue of privacy. Suppose you want to live your life and not know you're living your life with a 75 percent probability you'll develop breast cancer by the time you're 55 years old?"